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Weekly Update Friday 13th February 2015

Date sent: Friday 13 February 2015

  1. The current and forthcoming pressures facing primary care
  2. What practices should be asking themselves to prepare for the future
  3. Essential components for collaboration
  4. Benefits to patients and practices
  5. Legal pros and cons
  6. Other research and information

ToHealth We have now received the amendments to the contract to be issued to practices that have expressed an interest in delivering the health checks. The LMC has asked Porter Dodson to check the contract and we will confirm with practices early next week any comments received.

Lymphoedema The CCG have confirmed that they have agreed to commission a Doppler measuring service from Somerset Partnership which will be provided from their recently established Ambulatory Care sites (although a site for Taunton has yet to be finalised).This will form an important part of the pathway for the lymphoedema service which will enable patients with low and stable needs to be discharged to primary care. Some practices may choose to continue to provide Doppler testing for these patients or refer them to the commissioned Doppler service. Likewise for patients with leg ulcers needing further assessment for possible arterial insufficiency will be able to refer to this service. Final discussions are being held and once concluded the plan will be to share the details of the lymphoedema care pathway with the LMC and then with member practices with the aim of the new service arrangements starting on 1st April. 

One Page Locum Pack The LMC Locum representative Dr Tim Horlock has worked with fellow locums to update the previous Locum pack to make it simpler for both the practice and the Locum. To download the pack and the guidance please use the following links:

Locum Pack

The Care Certificate The Care certificate will be launched from March 2015 for all new employees in health and social care as part of their induction, Skills for health, Health education England and NHS employers have produced supporting guidance for employers and this will also be supported by the education trust with the rolling programme.

Details and supporting material can be found at the following links 

NHS Employers           Care Certificate Materials

It is not the intention or expectation that the Care Certificate will be accredited as a national qualification. The Care Certificate does not require local accreditation by any awarding body or Higher Education Institution, and there is no requirement for it to have external quality assurance. However individual employers may wish to seek accreditation of the learning or external quality assurance. It is however an expectation that the Care Certificate would provide evidence towards QCF qualifications and Apprenticeships across both Health and Social Care.

Recognition  of Acute Sepsis in Primary Care A recent case elsewhere in the Region has prompted a reminder about the importance of being  aware of the possibility of sepsis in primary care. In the case  in point a patient with a  pancreatic stent in situ developed sepsis and died.  Missing overwhelming bacterial infection that leads to death is every GP’s nightmare, and diagnosis can be difficult, but this is a significant cause of death in younger people as well as  the frail elderly so  it is wise always to keep the possibility at the back of your mind , especially when dealing with  a non-specifically unwell patient who has risk factors for sepsis.

The UK Sepsis Trust, in collaboration with the RCGP, has published some excellent guidance that emphasises the need to think of the possibility of severe infection,  to make and act upon basic clinical observations, and to safety net patients  who are not referred at the time.

Depo Provera Patient Group Direction (PGD) Somerset CCG has produced a new PGD for Depo Provera which is now available on the Somerset CCG PGD Web Page under the heading ‘Contraception’.

If you wish to use this PGD in your practice, please visit the PGD Web Page to download it and complete the declaration on page 2.  If you haven’t done so already, you should ensure that you remove all old copies from circulation and archive them for your records because they are no longer valid. 

It should be noted that the new PGD is significantly different to previous versions. Please take the time to read the document, ensure that your practice is up to date and that you are competent to work under the new PGD.  The document contains links to the most recent Faculty of Sexual and Reproductive Health (FSRH) guidance on progesterone only injectables and other useful guidance that nurses working under the PGD should ensure that they are familiar with.